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William C. Altreuter
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Wednesday, June 17, 2009

Timothy Noah provides a good overview of the world's health care systems by way of a review of T.R. Reid's forthcoming book. It is extremely irritating to consider that the US system essentially combines the worst features of every other plan out there. It troubles me also that the plan Obama appears to have in mind seems to assume that the present price model for the provision of medical care is somehow an absolute. In fact, treating visits, tests and procedures as different price points is a completely arbitrary construct, and certainly not something that was brought down inscribed on tablets of stone (or aspirin). We are hearing a great deal about how physicians ordering too many expensive tests drives up costs, and no doubt that is true. (We haven't been hearing so much about the cost of medical malpractice this go-round, and I wonder if that's because the medical community realizes that the myth of a malpractice crisis has been exposed, or if it is just that they know that nobody's in the mood for their whining this time.)

I'm not so sure that making the present system more efficient is necessarily the answer, but that appears to be where we are driving.

It's not going to happen, but what I'd like to hear is a description of the ideal healthcare system. I'd like to hear doctors describe it, and I'd like to hear economists describe it, and I would like to hear healthcare administers describe it, and then I'd like to work backwards from the systems they describe, and construct something as close to that as possible. TCA is fond of saying that she'd be happy if everyone got what members of Congress get, and I'd be surprised if following my proposed methodology didn't bring us to a system like that.

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